How to Handle Overwhelming Medical Bills

What to do when you owe more than you can pay.

Meryl Davids Landau
Photograph: DNY59

If you develop a major illness, the number of bills in the mail could dwarf your get-well cards. Hospitals, doctors and other technicians all bill separately—even for a single procedure—which leads to a barrage of confusing invoices.

Here’s how to cope: Stash the bills in an out of the way spot on your kitchen counter until you get your insurance company’s “explanation of benefits” (EOB) for each expenditure. Then match each bill with your insurer’s description, which details how much it’s paying and, assuming your treatment was in-network, how much the provider can charge you. Gerri Monaghan was stunned when hospital and doctor bills from her lawyer-husband’s brain cancer arrived, listing what the insurance company paid and informing her in big red letters that she and her husband were “responsible for the remainder.” Fortunately, she knew that providers are legally bound to accept the amount they’ve contracted with the insurer. “When I confronted them, they all quickly retreated, but they never should have tried to get that money from me in the first place,” fumes Monaghan, who wrote about her experiences as her husband’s healthcare advocate in The Power of Two.

If you legitimately owe more than you can handle, don’t be afraid to ask for a price break. Call the hospital or doctor’s billing office and ask to speak with a manager with decision-making power. In a friendly tone, let them know what you can realistically afford. Paying a lump sum in cash gives you the best bargaining position. “Providers typically wait 60 days for insurance to pay, so getting even half the amount they’re owed right away is often a good deal,” says Michelle Katz, author of Healthcare for Less. But if you need to pay it out monthly, many will still agree to a discount. Katz’s suggested script: “I received your bill and it is much more than I can afford. I have gone over my budget and can pay X now, in cash to cover the whole thing. [Or Y each month for a specified number of months]. I’d really appreciate your working with me on this to find a resolution that works for both of us.”

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